Efficacy and Safety of Rivaroxaban versus Warfarin for the Treatment of Acute Pulmonary Embolism: A Real-World Study
| Autor: | Tao Wang, Xinni Wang, Yanghang Chen, Nuofu Zhang, Linli Duan, Wenjun He, Yan Huang, Yehui Guo, Cheng Hong, Chunli Liu, Jian Wang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research Article Subject medicine.drug_class medicine.medical_treatment 030204 cardiovascular system & hematology Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Rivaroxaban Risk Factors Neoplasms medicine Pulmonary angiography Humans 030212 general & internal medicine Thrombus RC254-282 Frailty QH573-671 business.industry Anticoagulant Warfarin Neoplasms. Tumors. Oncology. Including cancer and carcinogens Cell Biology General Medicine Thrombolysis Middle Aged medicine.disease Pulmonary embolism Regimen Treatment Outcome Anesthesia Molecular Medicine Female business Pulmonary Embolism Cytology medicine.drug Research Article |
| Zdroj: | Analytical Cellular Pathology, Vol 2020 (2020) Analytical Cellular Pathology (Amsterdam) |
| ISSN: | 2210-7177 |
| DOI: | 10.1155/2020/6813492 |
| Popis: | Background. Pulmonary embolism (PE) is a life-threatening disease. Target-specific anticoagulant rivaroxaban is a direct factor Xa inhibitor that can be safely used without laboratory monitoring. Objective. To investigate the efficacy and safety of rivaroxaban versus warfarin for the treatment of acute pulmonary thromboembolism in real-world clinical practice. Method. This was a semiretrospective, semiprospective, and real-world trial involving 128 patients with acute symptomatic pulmonary embolism with or without active tumor or frailty. We compared rivaroxaban to the standard therapy consisting of low-molecular-weight heparin combined with warfarin. The primary efficacy outcome was absorption of thrombus. The principal safety outcome was bleeding episode. Results. There was no significant difference in thrombus absorption between rivaroxaban and standard therapy after 3-month treatment (P=0.798, 95% confidence interval (CI) 0.686 to 1.336) or more than 6-month treatment (P=0.534, 95% confidence interval (CI) 0.795 to 1.556). There was no decline in efficacy (including computed tomographic pulmonary angiography and recurrence) when the rivaroxaban dose was reduced to 10 mg once daily after 3 months of administration. The ratio of patients without bleeding was 48.84% for rivaroxaban and 19.05% for standard therapy (P=0.001). There was no significant difference in rivaroxaban monotherapy subgroups (including frail patients, tumor patients, and thrombolysis or nonthrombolysis at intermediate-high-risk patients). Conclusion. In this real-world study, the efficacy and safety of rivaroxaban alone was not different to standard therapy for pulmonary emboli absorption. With an extension in treatment duration, the rivaroxaban regimen had a higher efficacy and safety than standard therapy and there was no decline in treatment efficacy when the rivaroxaban dose was reduced to 10 mg once daily. |
| Databáze: | OpenAIRE |
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